Active NPI
Mallory Turnbull, MA, CCC-SLP
- Speech-Language Pathologist
- Novato, CA
National Provider Identifier
1780155135
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 26418
- Practice address
- 100 Rowland Way
Novato, CA 94945-5011 - Phone
- (415) 209-7700
- NPI assigned
- Dec 11, 2018
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 26418 | CA | Primary |
Addresses
Primary practice location
100 Rowland Way
Novato, CA 94945-5011
Mailing address
1289 Brown CT
San Leandro, CA 94579-1231
Phone (510) 919-7284
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 26418 | Other | CA | CALIFORNIA STATE LICENSE |
| 14172226 | Other | ASHA CERTIFICATION |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 26418 | CA | MD | General Practice Dentistry |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1544486400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1544486400000",
"number": "1780155135",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1289 BROWN CT",
"city": "SAN LEANDRO",
"state": "CA",
"postal_code": "945791231",
"telephone_number": "510-919-7284"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "100 ROWLAND WAY",
"city": "NOVATO",
"state": "CA",
"postal_code": "949455011",
"telephone_number": "415-209-7700"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TURNBULL",
"first_name": "MALLORY",
"credential": "MA, CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-12-11",
"last_updated": "2018-12-11",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "CA",
"license": "26418",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CALIFORNIA STATE LICENSE",
"identifier": "26418",
"state": "CA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ASHA CERTIFICATION",
"identifier": "14172226",
"state": null
}
],
"endpoints": [],
"other_names": []
}Other providers in Novato, CA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.